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10 Pearls: Radiation protection of patients in CT 1. Perform scan only if it is indicated! It is estimated that a significant number of imaging examinations are unnecessary Consultation between the referring physician and the radiologist is recommended Ultra Sound Magnetic Resonance Imaging 2. Encourage use of alternative nonionizing imaging (MRI,US) when appropriate especially in younger patients Please notify staff if you think you might be pregnant! 3. Always check if patient may be pregnant Use special signs and informative material notifying patients that they MUST disclose any possibility of pregnancy 4. High quality /Crisp images may look nice but they impart higher radiation dose to patients Start using images with some noise without loss of diagnostic information Image Quality: Unnecessarily high Image Quality: Adequate for diagnosis Images courtesy of: MK Kalra, S. Singh, MGH Webster Center for Advanced Research and Education in Radiation 5. Use indication-specific CT protocols for each body region, e.g. for lung nodule follow up or kidney stones, diagnostic images can be obtained at 50-75% lower radiation dose compared to routine or general use protocols Related Poster! 10 Pearls: Appropriate referral of CT examinations https://rpop.iaea.org/RPOP/RPoP/Content/Documents/Whitepapers/poster-ctappropriate-referrals.pdf http://rpop.iaea.org Page 1 of 2 Computed Tomography Patient Radiation Protection 10 Pearls: Radiation protection of patients in CT 6. Multiple pass or phase CT should NOT be performed routinely Multiphase CT can increase the dose by as much as 2-3 folds over single phase CT Images courtesy of: MK Kalra, S. Singh, MGH Webster Center for Advanced Research and Education in Radiation 7. Adjust exposure parameters according to patient and body part Images courtesy of: MK Kalra, S. Singh, MGH Webster Center for Advanced Research and Education in Radiation Small patient Large patient 8. Know your equipment: Learn how to adjust the parameters of the automatic exposure control (AEC) system to fine tune radiation dose for different clinical indications and body regions Most body CT examinations should be performed with use of AEC 9. Good technique: Lower kVp, mAs, Higher pitch Restrict scan length to what is necessary Always center the area of interest in isocenter of CT gantry All CT protocols should state the start and end location for different clinical indications Thin slices only when necessary Examination Images courtesy of: MK Kalra, S. Singh, MGH Webster Center for Advanced Research and Education in Radiation PE=Pulmonary embolism Shorter scan length: 20-30% dose reduction Reference Levels (CTDIvol)* CT head 75 mGy CT adult abdomen 25 mGy CT adult chest 21 mGy CT paediatric abdomen (5 y old) 20 mGy CT paediatric head (5 y old) 34 mGy *NCRP Report No. 172 10. Pay attention to radiation dose values and compare with diagnostic reference levels (DRLs) Be aware of CT dose metrics and recommended dose levels for different body regions Related Poster! 10 Pearls: Appropriate referral of CT examinations https://rpop.iaea.org/RPOP/RPoP/Content/Documents/Whitepapers/poster-ctappropriate-referrals.pdf http://rpop.iaea.org Page 2 of 2 Computed Tomography Patient Radiation Protection